Article information
Abstract
Novel treatment strategies and new information concerning the management of moderate to severe psoriasis justify a reassessment of the role of the classic therapies in this setting. This consensus statement evaluates narrowband UV-B therapy, which is currently considered the phototherapy option of choice in psoriasis because of its risk-to-benefit ratio. The role of excimer laser and photodynamic therapies are also discussed. These targeted therapies are still only available in a small number of centers in Spain and are used principally in the treatment of localized and recalcitrant forms of psoriasis. We discuss the efficacy and safety of phototherapy as well as treatment regimens, combination therapy, and clinical considerations relating to the characteristics of the patient or the disease.
Keywords:
Phototherapy
Narrowband UV-B
Psoriasis
Photodynamic therapy
Excimer laser
Resumen
Los nuevos conocimientos y estrategias terapéuticas y de manejo de la psoriasis moderada y grave justifican la reevaluación del papel de los tratamientos clásicos en el manejo de estas formas de la enfermedad. En el presente documento se lleva a cabo la evaluación de la terapia ultravioleta B de banda estrecha (UVBBE) considerada en la actualidad, por su relación entre riesgo y beneficio, como la de primera elección en la fototerapia de la psoriasis. Por otra parte, se ha revisado y evaluado la terapia con sistemas y láseres de excímeros y la terapia fotodinámica en la psoriasis. El uso de estas terapias localizadas, aún limitado a pocos centros a escala nacional, constituye una alternativa terapéutica fundamentalmente en formas limitadas y recalcitrantes de psoriasis. En el siguiente documento se evalúan el perfil de eficacia, la seguridad, los esquemas terapéuticos, el tratamiento combinado y diversas consideraciones clínicas en función del perfil del paciente o de las características de la enfermedad.
Palabras clave:
Fototerapia
HUBE
Psoriasis
Terapia fotodinámica
Excímero
Full text is only aviable in PDF
References
[1.]
L. Puig, J.M. Carrascosa, E. Dauden, J.L. Sanchez-Carazo, C. Ferrandiz, Sanchez-Regaña, et al.
Guias españolas basadas en la evidencia sobre el tratamiento de la psoriasis moderada a grave con fármacos biológicos.
Actas Dermosifiliogr, 100 (2009), pp. 386-413
[2.]
A. Nast, I.B. Kopp, M. Augustin, K.B. Banditt, W.H. Boehncke, M. Follmann, et al.
Deutsche Dermatologische Gesellschaft (DDG); Berufsverband Deutscher Dermatologen (BVDD). Evidence-based (S3) guidelines for the treatment of psoriasis vulgaris.
J Dtsch Dermatol Ges., 5 (2007), pp. 1-119
[3.]
J.A. Parrish, K.F. Jaenicke.
Action spectrum for phototherapy of psoriasis.
J Invest Dermatol., 76 (1981), pp. 359-362
[4.]
B. Ortel, H. Honigsmann.
Phototherapy and photochemotherapy.
Photodermatology, pp. 223-240
[5.]
M.S. Duthie, I. Kimber, M. Norval.
The effects of ultraviolet radiation on the human immune system.
Br J Dermatol., 140 (1999), pp. 995-1009
[6.]
O. Larko, G. Swanbeck.
Home solarium treatment of psoriasis.
Br J Dermatol., 101 (1979), pp. 13-16
[7.]
K. Yano, K. Kadoya, K. Kajiya, Y.K. Hong, M. Detmar.
Ultraviolet B irradiation of human skin induces an angiogenic switch that is mediated by upregulation of vascular endothelial growth factor and by downregulation of thrombospondin-1.
Br J Dermatol., 152 (2005), pp. 115-121
[8.]
J.C. Van der Leun, H. Van Weelden.
UVB phototherapy; principles, radiation sources, regimens.
Curr Probl Dermatol., 15 (1986), pp. 39-51
[9.]
O. Larko.
Treatment of psoriasis with a new UVB-lamp.
Acta Derm Venereol (Stockh), 69 (1989), pp. 357-359
[10.]
C. Green, J. Ferguson, T. Lakshmipathi, B.E. Johnson.
311nm UVB phototherapy: an effective treatment for psoriasis.
Br J Dermatol., 119 (1988), pp. 691-696
[11.]
E. Picot, L. Meunier, M.C. Picot-Debeze, J.L. Peyron, J. Meynadier.
Treatment of psoriasis with a 311-nm UVB lamp.
Br J Dermatol., 127 (1992), pp. 509-512
[12.]
R.S. Dawe.
A quantitative review of studies comparing the efficacy of narrow-band and broad-band ultraviolet B for psoriasis.
Br J Dermatol., 149 (2003), pp. 655-680
[13.]
P.M. Gordon, L. Diffey, J.N.S. Matthews, P.M. Farr.
A randomized comparison of narrow-band TL-01 and PUVA photochemotherapy for psoriasis.
J Am Acad Dermatol., 41 (1999), pp. 728-732
[14.]
A. Tanew, S. Radakovic-Fijan, M. Schemper, H. Honigsmann.
Narrow-band UV-B phototherapy vs photochemotherapy in the treatment of chronic plaque-type psoriasis. A paired comparison study.
Arch Dermatol., 135 (1999), pp. 519-524
[15.]
M.B. Koek, E. Buskens, H. van Weelden, P.H. Steegmans, C.A. Bruijnzeel-Koomen, V. Sigurdsson, et al.
Home versus outpatient ultraviolet B phototherapy for mild to severe psoriasis: pragmatic multicentre randomised controlled non-inferiority trial (PLUTO study).
BMJ, 338 (2009), pp. b1542
[16.]
G. Boztepe, A. Karaduman, S. Sahin, M. Hayran, F. Kolemen.
The effect of maintenance narrow-band ultraviolet B therapy on the duration of remission for psoriasis: a prospective randomized clinical trial.
Int J Dermatol., 45 (2006), pp. 245-250
[17.]
J.M. Carrascosa, X. Bigata.
UVB terapia de banda estrecha: experiencia en la práctica clínica y factores predictivos de respuesta.
Actas Dermosifiliogr, 91 (2000), pp. 555-562
[18.]
V. Leenutaphong, P. Nimkulrat, S. Sudtim.
Comparison of phototherapy two times and four times a week with low doses of narrow-band ultraviolet B in Asian patients with psoriasis.
Photodermatol Photoimmunol Photomed, 16 (2000), pp. 202-206
[19.]
R.S. Dawe.
Using ‘number needed to treat’ to express the magnitudes of benefit of ultraviolet B phototherapy and of antitumour necrosis factor-alpha therapies for psoriasis.
Br J Dermatol., 162 (2010), pp. 456-457
[20.]
S.R. Feldman, R. Garton, W. Averett, R. Balkrishnan, J. Vallee.
Strategy to manage the treatment of severe psoriasis: considerations of efficacy, safety and cost.
Expert Opin Pharmacother, 4 (2003), pp. 1525-1533
[21.]
R.S. Dawe.
Towards optimal regimens for the UVB phototherapy of psoriasis: A mathematical model.
Acta Derm Venereol, 84 (2004), pp. 259-264
[22.]
M.M. Kleinpenning, T. Smits, J. Boezeman, P.C.M. van de Kerkhof, A.W.M. Evers, M.J.P. Gerritsen.
Narrowband ultraviolet B therapy in psoriasis: randomized double-blind comparison of high-dose and low-dose irradiation regimens.
Br J Dermatol., 161 (2009), pp. 1351-1356
[23.]
R.S. Dawe.
Comparing narrowband ultraviolet B treatment regimens for psoriasis.
Br J Dermatol., 161 (2009), pp. 1215-1216
[24.]
R.M. Youssef, D. Mahgoub, H.M. Mashaly, E. El-Nabarawy, N. Samir, M. El-Mofty.
Different narrowband UVB dosage regimens in dark skinned psoriatics: a preliminary study.
Photodermatol Photoimmunol Photomed, 24 (2009), pp. 256-259
[25.]
J.M. Carrascosa.
Fototerapia y fotoquimioterapia.
Actas Dermosifiliogr, 95 (2004), pp. 259-284
[26.]
M. Gloor, A. Scherotzke.
Age dependence of ultraviolet light induced erythema following narrow-band UVB exposure.
Photodermatol Photoimmunol Photomed, 18 (2002), pp. 121-126
[27.]
A.W.M. Evers, M.M. Kleinpenning, T. Smits, J. Boezeman, P.C.M. Van de Kerkhof, F.W. Kraaimaat, et al.
Itch and scratching as predictors of time to clearance of psoriasis with narrow-band ultraviolet B therapy.
Br J Dermatol., 161 (2009), pp. 542-546
[28.]
P.G. Calzavara-Pinton, C. Zane, E. Candiago, F. Facchetti.
Blisters on psoriatic lesions treated with TL-01 lamps.
Dermatology, 200 (2000), pp. 115-119
[29.]
G.J. Fisher, S. Kang, J. Varani, Z. Bata-Csorgo, Y. Wan, S. Datta, et al.
Mechanisms of photoaging and chronological skin aging.
Arch Dermatol., 138 (2002), pp. 1462-1470
[30.]
N.K. Gibbs, N.J. Traynor, R.M. MacKie, I. Campbell, B.E. Johnson, J. Ferguson.
The phototumorigenic potential of broad-band (270–350nm) and narrow-band (311–313nm) phototherapy sources cannot be predicted by their edematogenic potential in hairless mouse skin.
J Invest Dermatol., 104 (1995), pp. 359-363
[31.]
T.Y. Tzung, T.M. Runger.
Assessment of DNA damage induced by broadband and narrowband UVB in cultured lymphoblasts and keratinocytes using the comet assay.
Photochem Photobiol., 67 (1998), pp. 647-650
[32.]
F.R. De Gruijl.
Long-term side effects and carcinogenesis risk in UVB therapy.
The Fundamental Bases of Phototherapy, pp. 153-170
[33.]
R.M. Hearn, A.C. Kerr, K.F. Rahim, J. Ferguson, R.S. Dawe.
Incidence of skin cancers in 3867 patients treated with narrow-band ultraviolet B phototherapy.
Br J Dermatol., 159 (2008), pp. 931-935
[34.]
E. Lee, J. Koo, T. Berger.
UVB phototherapy and skin cancer risk: a review of the literature.
Int J Dermatol., 44 (2005), pp. 355-360
[35.]
S.H. Ibbotson, D. Bilsland, N.H. Cox, R.S. Dawe, B. Diffey, C. Edwards, et al.
An update and guidance on narrowband ultraviolet B phototherapy: a British Photodermatology Group Workshop Report.
Br J Dermatol, 151 (2004), pp. 283-297
[36.]
T. Meola Jr., N.A. Soter, H.W. Lim.
Are topical corticosteroids useful adjunctive therapy for the treatment of psoriasis with ultraviolet radiation? A review of the literature.
Arch Dermatol., 127 (1991), pp. 1708-1713
[37.]
M.J. LeVine, J.A. Parrish.
The effect of topical fluocinolone ointment on phototherapy of psoriasis.
J Invest Dermatol., 78 (1989), pp. 157-162
[38.]
J.Y. Koo.
Tazarotene in combination with phototherapy.
J Am Acad Dermatol., 39 (1998), pp. 144-148
[39.]
W.K. Woo, K.E. McKenna.
Combination TL01 ultraviolet B phototherapy and topical calcipotriol for psoriasis: a prospective randomized placebo-controlled clinical trial.
Br J Dermatol., 149 (2003), pp. 146-150
[40.]
R. Schiener, S.C. Behrens-Williams, H. Pillekamp, P. Kaskel, R.U. Peter, M. Kerscher.
Calcipotriol vs tazarotene as combination therapy with narrowband ultraviolet B (311nm): efficacy in patients with severe psoriasis.
Br J Dermatol., 143 (2000), pp. 1275-1278
[41.]
K.E. McKenna, R.S. Stern.
Photosensitivity associated with combined UVB and calcipotriene therapy.
Arch Dermatol., 131 (1995), pp. 1305-1307
[42.]
J. Karvonen, E.L. Kokkonen.
Ruotsalainen E. 311nm UVB lamps in the treatment of psoriasis with the Ingram regimen.
Acta Derm Venereol, 69 (1989), pp. 82-85
[43.]
K. Storbeck, E. Holzle, M. Schurer.
Narrow-band UVB (311nm) versus conventional broad-band UVB with and without dithranol in phototherapy for psoriasis.
J Am Acad Dermatol., 28 (1993), pp. 227-231
[44.]
M. Lebwohl, J. Martinez, P. Weber, R. DeLuca.
Effects of topical preparations on erythemogenicity of UVB: implications for psoriasis therapy.
J Am Acad Dermatol., 32 (1995), pp. 469-474
[45.]
D.A. Brualla, M. Sanchez-Reñaga, J. Massana, J. Molinero, R. Ojeda, P. Umbert.
Optimización de la fototerapia UVB 311nm con ácido oleico.
Actas Dermosifiliogr, 94 (2003), pp. 66-67
[46.]
E. Fetil, S. Ozka, M.C. Soyal, T. Ilknur, Y. Erdem, A.T. Gunes.
Effects of topical petrolatum and salicylic acid on the erythemogenicity of UVB.
Eur J Dermatol., 12 (2002), pp. 154-156
[47.]
S.A. George, D.J. Bilsland, N.J. Wainwright, J. Ferguson.
Failure of coconut oil to accelerate psoriasis clearance in narrowband UVB phototherapy or photochemotherapy.
Br J Dermatol., 128 (1993), pp. 301-305
[48.]
D. Seckin, I. Usta, Z. Yazici, A. Senol.
Topical 8-methoxypsoralen increases the efficacy of narrowband ultraviolet B in psoriasis.
Photodermatol, Photoimmunol Photomedicine, 25 (2009), pp. 237-241
[49.]
C. Green, T. Lakshmipathi, B.E. Johnson, J. Ferguson.
A comparison of the efficacy and relapse rates of narrowband UVB (TL-01) monotherapy vs etretinate (re-TL-01) vs etretinate-PUVA (re-PUVA) in the treatment of psoriasis patients.
Br J Dermatol., 127 (1992), pp. 5-9
[50.]
M. Ozdemir, B. Engin, I. Baysal, I. Mevlitoğlu.
A randomized comparison of acitretin-narrow-band TL-01 phototherapy and acitretin-psoralen plus ultraviolet A for psoriasis.
Acta Derm Venereol, 88 (2008), pp. 589-593
[51.]
M. Lebwohl, L. Drake, A. Menter, J. Koo, A.B. Gottlieb, M. Zanolli, et al.
Consensus conference: acitretin in combination with UVB or PUVA in the treatment of psoriasis.
J Am Acad Dermatol., 45 (2001), pp. 544-553
[52.]
R. Mahajan, I. Kaur, J. Kanwar.
Methotrexate/narrowband UVB phototherapy combination vs. narrowband UVB phototherapy in the treatment of chronic plaque-type psoriasis — a randomized single-blinded placebo-controlled study.
J Eur Acad Dermatol Venereol, 24 (2010), pp. 595-600
[53.]
P. Asawanonda, Y. Nateetongrungsak.
Methotrexate plus narrowband UVB phototherapy versus narrowband UVB phototherapy alone in the treatment of plaque-type psoriasis: a randomized, placebo-controlled study.
J Am Acad Dermatol., 54 (2006), pp. 1013-1018
[54.]
P. Calzavara-Pinton, G. Leone, M. Venturini, R. Sala, D. Colombo, I.L. La Parola, et al.
A comparative non-randomized study of narrowband (NB) (312 +/− 2nm) UVB phototherapy versus sequential therapy with oral administration of low-dose Cyclosporin A and NB-UVB phototherapy in patients with severe psoriasis vulgaris.
Eur J Dermatol., 15 (2005), pp. 470-473
[55.]
L. Kircik, J. Bagel, N. Korman, A. Menter, C.A. Elmets, J. Koo, et al.
Utilization of narrow-band ultraviolet light B therapy and etanercept for the treatment of psoriasis (UNITE): efficacy, safety, and patient-reported outcomes.
J Drugs Dermatol., 7 (2008), pp. 245-253
[56.]
A. Lucas, I. Belinchon, M. Perez-Crespo, J. Mataix, I. Betlloch.
Successful response to narrow-band UVB in a patient undergoing concomitant treatment with adalimumab for psoriasis.
Australas J Dermatol., 49 (2008), pp. 173-174
[57.]
J.M. Carrascosa, X. Soria, C. Ferrandiz.
Effective management of a psoriatic flare with narrowband UVB phototherapy during efalizumab therapy without discontinuing treatment.
J Eur Acad Dermatol Venereol, 21 (2007), pp. 828-829
[58.]
S. Tyring, K.B. Gordon, Y. Poulin, R.G. Langley, A.B. Gottlieb, M. Dunn, et al.
Long-term safety and efficacy of 50mg of etanercept twice weekly in patients with psoriasis.
Arch Dermatol., 143 (2007), pp. 719-726
[59.]
A. Menter, S.K. Tyring, K. Gordon, A.B. Kimball, C.L. Leonardi, R.G. Langley, et al.
Adalimumab therapy for moderate to severe psoriasis: A randomized, controlled phase III trial.
J Am Acad Dermatol., 58 (2008), pp. 106-115
[60.]
A. Taneja, A. Racette, Z. Gourgouliatos, C.R. Taylor.
Broad-band UVB fiber-optic comb for the treatment of scalp psoriasis: a pilot study.
Int J Dermatol., 43 (2004), pp. 462-467
[61.]
R. Braun, L.K. Dotterud, E.S. Falk.
Comparison of betamethasone valerate solution with phototherapy (UVB comb) in scalp psoriasis treatment.
Acta Derm Venereol., 78 (1998), pp. 385
[62.]
D. de Berker.
Management of nail psoriasis.
Clinic Experimental Dermatol., 25 (2000), pp. 357-362
[63.]
Chalmers R, Hollis S, Leonardi-Bee J, Griffiths CEM, Marsland A. Interventions for chronic palmoplantar pustulosis (Review). The Cochrane Library. 2009; Issue 1. Available from: http://www.thecochranelibrary.com.
[64.]
G. Wang, C. Li, T. Gao, Y. Liu.
Clinical analysis of 48 cases of inverse psoriasis: a hospital-based study.
Eur J Dermatol., 15 (2005), pp. 176-178
[65.]
E. Seker, A.H. Erbil, Z. Kurumlu, H.B. Tastan, I. Etikan.
Comparison of the efficacy of local narrowband ultraviolet B (NB-UVB) phototherapy versus psoralen plus ultraviolet A (PUVA) paint for palmoplantar psoriasis.
J Dermatol., 34 (2007), pp. 435-440
[66.]
M. Rosenbach, S. Hsu, N.J. Korman, M.G. Lebwohl, M. Young, B.F. Bebo, et al.
Treatment of erythrodermic psoriasis: From the medical board of the National Psoriasis Foundation.
J Am Acad Dermatol., 62 (2010), pp. 655-662
[67.]
C.S. Jury, P. McHenry, A.D. Burden, R. Lever, D. Bilsland.
Narrowband ultraviolet B (UVB) phototherapy in children.
Clin Exp Dermatol., 31 (2006), pp. 196-199
[68.]
P. Zamberk, D. Velazquez, M. Campos, J.M. Hernanz, P. Lazaro.
Paediatric psoriasis-narrowband UVB treatment.
J Eur Acad Dermatol Venereol., 24 (2010), pp. 415-419
[69.]
A.E. Tauscher, A.B. Fleischer Jr., K.C. Phelps, S.R. Feldman.
Psoriasis and pregnancy.
J Cutan Med Surg., 6 (2002), pp. 561-570
[70.]
K. Menon, A.S. Van Voorhees, B.F. Bebo Jr., D.D. Gladman, S. Hsu, R.E. Kalb, for the National Psoriasis Foundation, et al.
Psoriasis in patients with HIV infection: from the medical board of the National Psoriasis Foundation.
J Am Acad Dermatol., 62 (2010), pp. 291-299
[71.]
E. Cicarma, C. Mørk, A.C. Porojnicu, A. Juzeniene, T.T. Tam, A. Dahlback, et al.
Influence of narrowband UVB phototherapy on vitamin D and folate status.
Exp Dermatol., 19 (2010), pp. e67-72
[72.]
A. Osmancevic, Wilhelmsen, O. Larko, A.M. Wennberg, A.L. Krogstad, D. Vitamin.
production in psoriasis patients increases less with narrowband than with broadband ultraviolet B phototherapy.
Photodermatol Photoimmunol Photomed, 25 (2009), pp. 119-123
[73.]
S.M. Langan, A. Heerey, M. Barry, L. Barnes.
Cost analysis of narrowband UVB phototherapy in psoriasis.
J Am Acad Dermatol., 50 (2004), pp. 623-626
[74.]
B. Bonis, L. Kemeny, A. Dobozy, Z. Bor, G. Szabo, F. Ignacz.
308nm UVB excimer laser for psoriasis.
Lancet North Am., 350 (1997), pp. 1522
[75.]
Z. Novak, B. Bonis, E. Baltas, I. Ocsovszki, F. Ignacz, A. Dobozy, et al.
Xenon Chloride ultraviolet B laser is more effective in treating psoriasis and in inducing T cell apoptosis than narrowband ultraviolet B.
J Photochem Photobiol B, 67 (2002), pp. 32-38
[76.]
Z. Novak, A. Berces, G. Ronto, E. Pallinges, A. Dobozy.
Efficacy of different UV-emitting light sources in the induction of T-cell apoptosis.
Photochem Photobiol., 79 (2004), pp. 434-439
[77.]
M. Trehan, C.R. Taylor.
High-dose 308nm excimer laser for the treatment of psoriasis.
J Am Acad Dermatol., 46 (2002), pp. 732-737
[78.]
S.R. Feldman, B.G. Mellen, T.S. Housman, R.E. Fitzpatrick, R.G. Geronemus, P.M. Friedman, et al.
Efficacy of the 308nm excimer laser for treatment of psoriasis: results of a multicenter study.
J Am Acad Dermatol., 46 (2002), pp. 900-906
[79.]
Y.L. He, X.Y. Zhang, J. Dong, J.Z. Xu, J. Wang.
Clinical efficacy of a 308nm excimer laser for treatment of psoriasis vulgaris.
Photodermatol Photimmunol Photomed, 23 (2007), pp. 238-241
[80.]
L. Han, A.K. Somani, Q. Huang, X. Fang, Y. Jin, L.H. Xiang, et al.
Evaluation of 308nm monochromatic excimer light in the treatment of psoriasis vulgaris and palmoplantar psoriasis.
Photodermatol Photoimmunol Photomed, 24 (2008), pp. 231-236
[81.]
W. Gerber, B. Arheilger, T.A. Ha, J. Hermann, H.M. Ockenfels.
Ultraviolet B 308nm excimer laser treatment of psoriasis: A new photherapeutic approach.
Br J Dermatol., 149 (2003), pp. 1250-1258
[82.]
S.P. Nistico, R. Sarceno, C. Schipani, A. Costanzo, S. Climenti.
Different applications of monochromatic excimer light in skin diseases.
Photomed Laser Surg., 27 (2009), pp. 647-654
[83.]
C.R. Taylor, A.L. Racette.
A 308-nm excimer laser for the treatment of scalp psoriasis.
Lasers Surg Med., 34 (2004), pp. 136-140
[84.]
W.L. Morison, D.F. Atkinson, L. Werthman.
Effective treatment of scalp psoriasis using the excimer (308nm) laser.
Photodermatol Photoimmunol Photomed, 22 (2006), pp. 181-183
[85.]
S.P. Nistico, R. Sarraceno, S. Stefanescu, S.A. Climenti.
308nm monochromatic excimer light in the treatment of palmoplantar psoriasis.
J Eur Acad Dematol Venereol, 20 (2006), pp. 523-526
[86.]
J. Trott, W. Gerber, S. Hammes, H.M. Ockenfels.
The effectiveness of PUVA treatment in severe psoriasis is significantly increased by additional UV 308-nm excimer laser sessions.
Eur J Dermatol., 18 (2008), pp. 55-60
[87.]
T. Fikrle, K. Pizinger.
The use of the 308nm excimer laser for the treatment of psoriasis.
J Dtsch Dermatol Ges., 1 (2003), pp. 559-563
[88.]
N. Pahlajani, B.J. Katz, A.M. Lozano, F. Muphy, A. Gottlieb.
Comparison of the efficacy and safety of the 308nm excimer laser for the treatment of localized psoriasis in adults and in children: A pilot study.
Pediatr Dermatol., 22 (2005), pp. 161-165
[89.]
A. Marchetti, S.R. Feldman, A.B. Kimball, R.R. Anderson, L.H. Miller, J. Martin, et al.
Treatment for mild to moderate recalcitrant plaque psoriasis: expected clinical and economic outcomes for first-line and second-line care.
Dermatol Online J, 11 (2005), pp. 1
[90.]
S. Gattu, R.M. Rashid, J.J. Wu.
308nm excimer laser in psoriasis vulgaris, scalp psoriasis and palmoplantar psoriasis.
JEADV, 23 (2009), pp. 36-41
[91.]
T. Smits, M.M. Kleinpennign, P.E. van Erp, P.C. van de Kerkhof, M.J. Gerritsen.
A placebo-controlled randomized study on the clinical effectiveness, immunohistochemical changes and protoporphyrin IX accumulation in fractionated 5-aminolaevulinic acid photodynamic therapy in patients with psoriasis.
Br J Dermatol., 155 (2006), pp. 429-436
[92.]
Y.K. Tandon, M.F. Yang, E.D. Baron.
Role of photodynamic therapy in psoriasis: a brief review.
Photodermatol Photoimmunol Photomed, 24 (2008), pp. 222-230
[93.]
W.H. Boehncke, W. Sterry, R. Kaufmann.
Treatment of psoriasis by topical photodynamic therapy with polychromatic light.
Lancet, 343 (1994), pp. 801
[94.]
P.E. Beattie, R.S. Dawe, J. Ferguson, S. Ibbotson.
Lack of efficacy and tolerability of topical PDT for psoriasis in comparison with narrowband UVB phototherapy.
Clin Exp Dermatol., 29 (2004), pp. 560-562
[95.]
J.D. Miller, E.D. Baron, H. Scull, A. Hsia, J.C. Berlin, T. McCormick, et al.
Photodynamic therapy with the phthalocyanine photosensitizer Pc 4: the case experience with preclinical mechanistic and early clinical-translational studies.
Toxicol Appl Pharmacol., 224 (2007), pp. 290-299
Copyright © 2011. Academia Española de Dermatología y Venereología and Elsevier España, S.L.
